The purpose of this agreement is to conduct an independent cognitive testing analysis of high-impact, chronic pain questions. The work includes performing a validity study to determine the interpretive and cognitive processes used by respondents when answering questions on high-impact, chronic pain. In-depth cognitive testing performed by the QDRL will improve the reliability and validity of the high-impact, chronic pain questions. Question design modifications developed in this project will be proposed for use in future national surveys such as the National Health Interview Survey (NHIS).